Effects of Biofeedback-Guided Training on Muscle Strength and Postural Alignment in Upper Cross Syndrome.

NCT07026084 | Recruiting

• 1 other identifier: Riphah IU Shizra Tayyab
• Study Type: interventional
• Target: 56
• Locations: 1 country
• Sites: 1

Brief Summary

This randomized controlled trial investigates the effects of biofeedback-guided training versus conventional therapy on muscle strength and postural alignment in patients with Upper Cross Syndrome. The study includes adults aged 25-45 years meeting diagnostic criteria for UCS, such as weak deep cervical flexors, restricted cervical ROM, forward head posture, increased thoracic kyphosis, and chronic neck pain \>3 months. Participants are divided into two groups: Group A biofeedback training and Group B conventional therapy, receiving 12 sessions over 4 weeks ,3sessions/week. Assessments are conducted at baseline, post-1st session, and weekly intervals using standardized measures.The study aims to compare the efficacy of biofeedback-guided training in improving strength and posture in UCS patients.

Conditions

Upper Extremity Problem; Muscle Weakness; Postural Kyphosis

Keywords

upper cross syndrome; forward head posture; young adults; bio feedback guided training; postural alignment

Outcome Measures

Primary Outcomes (1)

• cranio-cervical flexion test

  craniocervical flexion test to measure strength and endurance of Deep cervical flexors. it ranges from 20 mm of hg to 30 mm of Hg based on increased strength

  baseline to 4th week

Secondary Outcomes (8)

• NPRS

  total of 5 measurements taken at baseline, at the end of 1st, 2nd , 3rd and 4th week

• NECK DISABILITY INDEX

  total of 5 measurements taken at baseline, at the end of 1st, 2nd , 3rd and 4th week

• cervical Flexion

  baseline to 4th week

• cervical Extension

  baseline to 4th week

• cervical Rt rotation

  baseline to 4th week

Study Arms (2)

Experimental Group

EXPERIMENTAL

Biofeedback-Guided Strength Training: Hot Pack: Applied for 10 minutes, mild warmth sensation to relax muscles and prepare for exercise. 1\. BPU (Biofeedback Pressure Unit): performed at 5 pressure levels (22, 24, 26, 28, 30 mmHg). Each level involves a 10-second hold, with 30 seconds rest between levels. Targeted muscles: * Deep Cervical Flexors (Capitus Longus, Capitus Colli). * Rhomboids * Trapezius Total duration (BPU): 20 minutes/session, performed 3 times/week.

Other: Bio feedback training

Control Group

ACTIVE COMPARATOR

Conventional Therapy: Hot Pack: Applied for 10 minutes, mild warmth sensation to relax muscles and prepare for exercise. EXERCISE PROGRAM: * 1\. Supine: Neck curl with Chin Tucks (Deep Cervical Flexors Capitus Longus, Capitus Colli): 10 reps/session, holding each for 5 seconds. * 2\. Sitting: Chin tuck with Head pushing against palm. * 3\. Chin Up (Middle and Lower Trapezius): 10 reps/session, holding each for 5 seconds. * 4\. Scapular Squeezes (Rhomboids): 2-3 sets of 10 reps/session, holding each for 5 seconds * 5\. Doorway Pectoral Stretch (pect major) 2-3 reps, 30 sec hold (36) Total duration: 20 minutes/session, performed 3 times/week.

Other: conventional exercise program

Interventions

Bio feedback training OTHER

Hot Pack: Applied for 10 minutes, mild warmth sensation to relax muscles and prepare for exercise. 1\. BPU (Biofeedback Pressure Unit): performed at 5 pressure levels (22, 24, 26, 28, 30 mmHg). Each level involves a 10-second hold, with 30 seconds rest between levels. Targeted muscles: * Deep Cervical Flexors (Capitus Longus, Capitus Colli). * Rhomboids * Trapezius Total duration (BPU): 20 minutes/session, performed 3 times/week.

Experimental Group

conventional exercise program OTHER

Hot Pack: Applied for 10 minutes, mild warmth sensation to relax muscles and prepare for exercise. EXERCISE PROGRAM: * 1\. Supine: Neck curl with Chin Tucks (Deep Cervical Flexors Capitus Longus, Capitus Colli): 10 reps/session, holding each for 5 seconds. * 2\. Sitting: Chin tuck with Head pushing against palm. * 3\. Chin Up (Middle and Lower Trapezius): 10 reps/session, holding each for 5 seconds. * 4\. Scapular Squeezes (Rhomboids): 2-3 sets of 10 reps/session, holding each for 5 seconds• 5. Doorway Pectoral Stretch (pect major) 2-3 reps, 30 sec hold (36)Total duration: 20 minutes/session, performed 3 times/week.

Control Group

Eligibility Criteria

• Age: 25 Years - 45 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Adults aged 25-45 years with both genders.
• Individuals meeting the following diagnostic criteria for upper cross syndrome will be included:
• Reduced strength of deep cervical flexors = unable to maintain pressure beyond 22-24 mm Hg (assessed via cranio-cervical flexion test).
• Limited cervical range of motion (Flexion: \< 80 degrees, Extension: \< 70 degrees, Rotation: \< 90 degrees on both sides, Lateral Flexion: \< 20 degrees)
• Postural deviations: forward head posture (CVA \<50 degrees), increased thoracic kyphosis (via flexi curve \>45 degrees).
• Neck pain with a duration of over 3 months

You may not qualify if:

• History of recent neck surgery or injury.
• Patients with neurological disorders affecting muscle tone.
• Involvement in other physical therapy programs focused on UCS.
• Diagnosed musculoskeletal condition that could impact muscle performance.

Sponsors & Collaborators

• Riphah International University: lead

Study Sites (1)

Watch Guard Tech

Rawalpindi, Punjab Province, 46000, Pakistan

RECRUITING

MeSH Terms

Conditions

Muscle Weakness; Oculocerebral hypopigmentation syndrome type Preus

Condition Hierarchy (Ancestors)

Muscular Diseases; Musculoskeletal Diseases; Neuromuscular Manifestations; Neurologic Manifestations; Nervous System Diseases; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Signs and Symptoms

Study Officials

• Aisha Razzaq, PHD*

  Riphah International University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

IMRAN AMJAD, PHD

CONTACT

0332430125; imran.amjad@riphah.edu.pk

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, INVESTIGATOR
• Masking Details: Participants will be masked by using sealed envolpe method
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: comparison based study on effects of bio feedback guided training and conventional exercise prorocol on muscle strength and postural training in upper cross syndrome

Study Record Dates

• First Submitted: June 11, 2025
• First Posted: June 18, 2025
• Study Start: August 11, 2025
• Primary Completion: January 1, 2026
• Study Completion: January 1, 2026
• Last Updated: August 22, 2025

Record last verified: 2025-08

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)